Pancreatic Cancer Surgery

There are several options for pancreatic cancer surgery. Surgical procedures are often an important part of pancreatic cancer treatment. The extent of the surgical procedure and the specific type of procedure depends on many factors, chief among them the location of the tumor, the size of the tumor and its stage. More advanced and invasive cancers often require much more aggressive surgical procedures which can have their own risks and symptoms associated with them.

At the most basic level, for tumors for which there is no diagnosis yet, a simple biopsy procedure may be performed to make the diagnosis. A small piece of tumor is sent to a pathologist to analyze.

For those patients with known pancreatic cancer, two general types of surgical procedures may be offered: tumor resection surgery and paliative surgery.

Tumor Resection Pancreatic Cancer Surgery

Tumors confined to the distal part of the pancreas, the end of the body or tail, may be treated by a distal pancreatectomy. This procedure leaves the head of the pancreas but removes the body and tail, usually along with the spleen (which lies adjacent to the tail).

For more invasive and larger tumors which involve a large segment of the pancreas, a total pancreatectomy may be recommended. In this tumor resection procedure the entire pancrease is removed along with part of the stomach, small intestine, common bile duct, gallbladder, spleen and many lymph nodes in the area. Because the pancreas is removed in its entirety, this procedure requires special treatment afterward. In particular, these patients will not have normal digestion because of the lack of pancreatic enzymes. Therefore, they will be prescribed medications, such as digestive enzymes, to help aid in digestion. Additionally, because they cannot produce insulin, they will have diabetes. This may require treatment by insulin injections.

Paliative Pancreatic Cancer Surgery

In some patients, if the bile duct is obstructed by tumor compressing it, an endoscopic procedure can help. Using an endoscope, a long flexible scope that is passed through the patients mouth into their stomach and into their small intestine, a stent can sometimes be placed into the bile duct. This is a small expandable tube which helps to hold open the bile duct, allowing bile to flow normally through it.

Finally, sometimes pancreatic tumors block the flow of food out of the outlet of the stomach. This can cause significant discomfort and digestive problems. A gastric bypass may help to bypass this area directly into another portion of the small intestine.